1. Field of the Invention
The present invention relates to an intracoelomic suturing and ligating method for suturing and ligating a body tissue inside a body cavity of a living body using two manipulators.
2. Description of the Related Art
According to endoscopic surgery (also called laparoscopic surgery), it is customary to form a plurality of holes or incisions on the body surface of a patient, insert trocars (tubular instruments) respectively into the incisions to define forceps instrument passage ports, and introduce distal end portions of forceps instruments having shafts through the respective trocars into the body cavity of the patient for performing a surgical operation on the affected body part. End effectors such as a gripper for gripping a living tissue, scissors, an electrosurgical knife blade, etc., are mounted onto the distal end portions of the forceps instruments.
An endoscopic surgical operation performed by means of the forceps instruments requires a surgeon to be trained in advance, because a working space within the body cavity is small. Further, the forceps instruments need to be operated using the trocars as fulcrums. Since conventional forceps instruments that have heretofore been used do not have joints for making tilting movement on the distal end thereof, such forceps instruments tend to have a small degree of freedom, and the end effecter can be operated only on an extension of the shaft. Therefore, cases that can be handled in accordance with the usual training practice for endoscopic surgery are confined to a certain range. Moreover, a surgeon needs to be trained and have a considerably high level of skill in order to perform endoscopic surgery on other cases that do not fall within the limited range.
Attempts have been made to improve conventional forceps instruments, so as to develop a forceps instruments having a plurality of joints on the distal ends thereof (see, for example, U.S. Patent Application Publication No. 2009/0240263). Such a forceps instrument (or a manipulator) is free of the limitations and difficulties of conventional forceps instruments, can be operated easily, and can be applied to a wide variety of surgical cases. It is expected that the developed forceps instrument will be applied to surgical techniques that require intricate manipulative actions within small spaces, for example.
Endoscopic surgical operations involve a variety of surgical techniques. In particular, suturing and ligating are difficult to carry out in small spaces within body cavities, and should desirably be done easily. U.S. Patent Application Publication No. 2009/0240263, for example, has proposed a method of suturing and ligating a tissue in a body cavity using two manipulators each having a gripper opening and closing mechanism, a gripper rolling mechanism, and a gripper tilting mechanism. According to the proposed method, specifically, a surgeon operates one of the manipulators to grip a suture-needle assembly, and moves the distal end portion of the one manipulator along a circular path to wind the suture strand around the distal end portion of the other manipulator.